Dr. Charles Caldwell was a radical thinker in some ways with medicine. Raised and schooled as a Presbyterian teacher, he became a physician by attending the medical school in Philadelphia. He had several very important professional relationships with some of his mentors at the school, but the most important of these involved Benjamin Rush. With time, Dr. Caldwell developed his own way of interpreting diseases and health, and as a result had a number of philosophies that differed significantly from those promoted by Rush. Caldwell’s most important difference with Rush’s philosophy was his belief in the miasma and influence of the environment on disease patterns. Caldwell’s teachings claimed disease was spread aerially across a given area by the natural events taking place in climate and weather. To Caldwell, this was influenced by such local features as topography, geology, and water bodies.

Rush on the other hand tended to focus on the person-to-person transmission process for diseases, claiming many epidemics were influential upon the crowded urban settings and the proximity of people to each other. When it came to trying to understand the yellow fever, Rush was slow to accept the differences between bilious fever and the newly developing yellow fever that struck Philadelphia for the first time in decades in 1793. This epidemic disease was a recurring phenomenon, but was not native to the region according to Caldwell–nor was it the foreign born and introduced disease many physicians were claiming it to be.

Caldwell suspected Yellow fever was a local or domestic disease pattern, erupting due to recent changes in the local ecology. These changes were a result of the urbanization of this part of Pennsylvania. Philadelphia at the time was the only city to suffer from yellow fever, and like many local religious leaders, had a large following that in the subsequent years believed this was the result of God–another example of the Plague.

Caldwell blamed the warming off the atmosphere around Philadelphia for this disease behavior. He claimed that the rapid growth of this area and its inadequate or inefficient wind patterns due to buildings and topography made the city susceptible to the build up of local sources for miasma. For a short while, Rush even conceded to Caldwell’s claim that the disease was of domestic origin, but in the end Rush blamed the putrid smell of coffee beans that came in by way way of several shipping ports was the cause for these epidemics. Once again, following the 1797 epidemic of yellow fever in Philadelphia (and New York), Rush had to concede to his claim that coffee beans were the cost for this second yellow fever epidemic. By then, his interpretation of yellow fever as a variation of the older bilious fever theory he was following had also changed. Once again, Rush conceded to the greater credibility related to Caldwell’s theory for these epidemics over those of his earlier years.

The second yellow fever epidemic also impacted New York City considerably. This time the famous New York physician Samuel Mitchell would be included in the ongoing political and personal arguments developing about what the true cause for yellow fever could be. Mitchell also considered this epidemic to be of domestic or local origin, and in the months and years to come developed a number of different theories and new terms regarding its cause. Mitchell coined the term speton for example to defeine the ammonia-rich smell or putrescence of some yellow fever prone settings in the New York urban setting. Mitchell also tried to develop a number of new chemically based theories for the development of this former “miasma” based on the chemistry of minerals and soils, and the impacts of natural events such as the fossilized oil or coal beds, hail storms and lightning events on any resources even distantly related to the places where yellow fever seemed to prevail.

Mitchell and Caldwell had similar domestic theories for the sudden surge in local yellow fever epidemics. But these arguments both had with Rush were not very becalming to Philadelphia nad New York residents. Both of these cities lost tens of thousands of residents in just one month after the yellow fever returned in late sumemr of 1797. Many of these people may have considered the filth of the city and its unhealthy crowded living setting to be the primary cause for this problem. But as evidence shows elsewhere (local newspapers and personal papers of the religious leaders, reviewed elsewhere on this site) about this large migration en masse from these two cities, religious causes were also in peoples’ minds concerning this return of “the plague”.

Between 1797 and 1801, Caldwell wrote several essays trying to reduce the “errors” p;osed by Rush’s writings about the causes for this disease. Caldwell used his arguments to demonstrate the value of better understanding and recognizing diseases of local domestic origin. This article reviews his Oration on the geography of local endemic disease patterns. Once again, Caldwell uses fever to first make his argument about how a local endemic disease pattern can be recognized and better understood. In the months and years to come, Caldwell would relate other diseases endemic to a region to these same recurring seasonal disease patterns. He linked goiter for example, a nutrition deficiency and diet related illness, to the intermittent and remittent fevers of the back country. (This would even about this same time lead to his publication of another essay arguing Benjamin Smith Barton’s theory as to the causes for Goiter–covered elsewhere as well.)

The following essay is just one example of the political unrest Caldwell often caused in his profession. Caldwell would later be associated with the Transylvania medical school in Kentucky, and become the chief reason for its early closure just a few decades later. His eclecticism and eccentricities made him a doctor of his own political and professional class. Caldwell supported Mesmerism, and like a few other regular physicians became deeply involved in practicing this form of psychological medicine. He also favored the study of phrenology, and was one of the first promoters of this “anthropology” specialty (even favored by Harvard in the beginning of its US history) some time between 1813 and 1816. This also meant that Caldwell had some personal philosophy regarding racial differences and the natural selection process which were not widely accepted by many in the medical community.

Caldwell also had his own view of the definition of a healthy physical and mental lifestyle. He himself had to learn Greek and Latin leading to his early work as a teacher in the church schools setting; he felt that so too was this a responsibility of the future generations. He was also a strong promoted of physical activities to strengthen the body and improve our possibilities of surviving the environmental changes we are causing as new residents in a young country, now with a constantly changing environment due to urbanization and its transition into farming lands.

Finally, Caldwell defined his medical geography reasons for a vegetarian diet with this oration. This would later lead to the much larger vegetarian movement initiated by Rev. Sylvester Graham during Caldwell’s later years in life. (See also my section on Hudson Valley-Manhattan Quaker Shadrach Ricketson about this history and its promoter in England.) Aside from the eccentric Samuel Mitchell, Caldwell impacted a number of Mid-Atlantic-New York new thinkers in medical reform. Caldwell’s preachings about phrenology turned Orson Fowler and family into the most active promoters of alternative thinkers in medicine to impact both New York City and the entire Hudson Valley. His writings turned the pastoral setting of the hinterlands of the Valley into a haven for those searching for health and recovery, the perfect place for valetudinarians to remove to due to the consumption they suffered by being raised in the filth-ridden environments of local cities and large towns.

Caldwell did much to place himself one step above his colleagues philosophically, academically and intellectually. Rush’s 1786 oration of what we today might refer to as sequent occupancy was improved upon by Caldwell’s theories of diseases in the rural setting. Endemic disease patterns were very important to understand because these would most likely change as we settled the western parts of New York and Pennsylvania To prepare for these public health changes, Caldwell had an answer for anything and everything that might happen. This article also refers to his recommendations for people to prepare for any diseases they develop or produce due to their new lifestyles and living patterns and locations.